It doesn't help that I'm on Adderall, but if left to my own devices, would absolutely skip it. I'm assuming I benefit in the able to think way from it. Largely the only reason I know I missed a dose is if I find I lose my patience quickly with others.
The difference is that you’ve taken it medicinally for years, whereas most nootropics users are early users who are experimenting with high placebo priming.
Stimulant prescriptions have a high churn rate because many people take their first few doses and feel euphoric, then think it’s going to be like that forever. Fast forward a couple years and the fun is long gone so it’s a different story.
Nootropics forums are dominated by posts from people saying “Just took my first dose of $substance and I feel amazing!” which is the least useful measure of how well it will treat someone long term.
That said, sounds like we are largely in agreement? I have gotten where I assume everything is dominated by noise.